Takeaways from the World Health Assembly

The week long hard intense debates on global health at the 70th World Health Assembly in Geneva came to an end on 31st May 2017. The slow slog of the debates inside the Assembly Hall was a contrast to fast-paced side-events and discussions being held by non-State Actors. Issues were not just confined to the plenary and committee sessions of the World Health Assembly, but were creeping out into the official sessions and the side events taking place within and around the Palais des Nations.

The decisions and resolutions of the Assembly will appear on the website WHA70 where some early resolutions are already published.

IAPO side-events outcomes.

1. The Biotherapeutics & the next 70 years: Delivering on their potential for patients globally.

Co-sponsored by International Federation of Pharmaceutical Manufactures & Associations (IFPMA) and IAPO, and supported by an unrestricted educational grant from Roche, the event was a celebration of WHO’s 70 years of contribution to human health and wellbeing through conventional medicines and signposting the role biotherapeutics will play in the next 70 years. The take-home messages were:

Data and transparency were needed for increased uptake of biosimilars. Solid scientific data regarding the approval of a drug as well as post market survey once a drug has been approved and in the market were said to be important to both physicians and patients as this is what would build confidence for both uptake and prescription.

It was also agreed that there was a need to ensure that biotherapeutics were available for everyone and not just a few. Improving health literacy among patients and health providers was said to be key as we progress and for safe use, it was agreed that harmonization of guidelines be done in line with WHO standards. We must invest in health staff and infrastructure to support a Univesral Health Coverages where biotherapeutics will be available in a sufficient quantity and to international standards of quality and safety.

2. Global heart health and the road to 2025: Supporting a heart healthy agenda for the age of longevity​​

Co-hosted by Devex, IAPO, World Heart Federation and Norvatis, the event marked the release of an important report by Economist Intelligence Unit. The Global Heart Health Report created a Score Card and sought to assess the state of play of the world heart health as well as evaluate efforts in place to facilitate global healthy hearts. The following remarks were made as the some of the best approaches in addressing cardio vascular diseases;

A comprehensive multisectoral approach is required at a level beyond health ministries to include various sectors combined with a multidisciplinary approach in clinical practice where preventive care can be provided by other health profession groups. A strong patient voice with patients taking responsibility for their own care was also said to be key.

The importance of an integrated care system was stressed with Patrice Matchaba of Norvatis noting that even when we are successful in innovating around cardio vascular diseases, without an integrated care approach, it is impossible to succeed. The drug is not the only solution. Patients need to be discharged into communities that are integrated into health care to be able to offer appropriate post care.

It was also noted that because people are living longer there’s almost certainly going to be an increase in the number of people affected by cardio vascular diseases. Therefore it was agreed that primary health care in terms of focus on early detection and treatment is where the bulk of the focus should be.

However, additional work needs to be done in defining exactly how it is in primary health care we can structure these services in a way that optimizes what we are trying to do in reducing morbidity and mortality related to cardiovascular diseases.

Therefore the biggest challenge of identifying and bringing preventive care to primary level to reduce mortality, save lives and reduce costs of healthcare still remains.

Decisions and Resolutions by WHA

1. WHO director-general election outcome

This year’s annual meeting was particularly eventful, with the historic election of a new director-general, Dr Tedros Adhanom Ghebreyesus who will take over leadership in July. His win in a highly competitive race combined with excitement on him being the WHO’s first African leader, gives him a unique opportunity to make bold changes to the organization’s operations. We wish him all the best.

2. World Patient Safety Day

Patient alliances met with WHO Patient for Patient Safety (PFPS) team. PFPS say that they are planning on having a World Patient Safety Day. The date marked for this is 17th September each year. PFPS will need to get a WHO executive board and World Health Assembly resolution passed in 2018. We will all need to get together to make this happen.

3. World Sepsis Day

We congratulate Dr.Konrad Reinhart chairman of Global Sepsis Alliance and the entire Global Sepsis team who managed to get a resolution to create a World Sepsis Day passed unanimously by the WHA. This marks a quantum leap in the global fight against sepsis commonly referred to as ‘blood poisoning’, a life-threatening condition that arises when the body’s response to infection results in organ dysfunction or failure.

The resolution urges governments to strengthen policies and processes related to sepsis, especially to prevent infections and the further spread of antimicrobial resistance. It emphasizes the importance of reinforcing health worker training to recognize and deal effectively with the condition, improve tracking and reporting of cases, and promote research to develop more tools for sepsis diagnosis and treatment.

Further, the resolution requests that WHO develop a report on sepsis and guidance for its prevention and management. In addition, the resolution directs the Organization to help countries develop the necessary infrastructure, laboratory capacity, strategies and tools to reduce the burden of sepsis. It also asks WHO to work with partners to help developing countries gain access to quality, safe, efficacious and affordable sepsis treatments and tools for infection prevention and control, including immunization.

4. Coherence between Non-communicable Diseases and Sustainable Development Goals

In an effort to enhancing policy coherence between different spheres of policy making that have a bearing on attaining SDG target 3.4, on NCDs to reduce by one third premature mortality from NCDs through prevention and treatment by 2030, WHO will hold a global conference. The Conference will be hosted by the President of Uruguay from 18 to 20 October 2017 in Montevideo.

Delegates endorsed an updated set of policy options and interventions to help countries meet global targets to prevent and control non-communicable diseases. The new set includes 16 interventions known as “best buys” within WHO's global action plan for the prevention and control of NCDs 2013-2020.

Particular focus is placed on measures to reduce people’s exposure to factors that increase the risk of developing NCDs - including through taxation of tobacco and sugar-sweetened beverages; banning tobacco advertising, and reformulation of food products to reduce salt content. Interventions to improve management and control of NCDs include providing drug therapy for diabetes and hypertension, counselling for people who have had a heart attack or stroke or those at high risk of a cardiovascular event, and cervical cancer screening for women.

5. Refugee and migrant health

Delegates asked the Director-General to provide advice to countries in order to promote the health of refugees and migrants, and to gather evidence that will contribute to a draft global action to be considered at the 72nd World Health Assembly in 2019. They also encouraged member states to use the framework of priorities and guiding principles to promote the health of refugees and migrants developed by WHO, in collaboration with IOM and UNHCR, to inform discussions among member states and partners engaged in the development of the UN global compact on refugees and the UN global compact for safe, orderly and regular migration.

6. Cancer

With Cancer ranked as the second leading cause of death globally, delegates endorsed a set of measures to improve and scale up access to prevention; early diagnosis: prompt, accessible treatment, and palliative care for cancer. They highlighted the need to intensify cancer prevention and control as critical to achieving global targets to reduce the burden of non-communicable diseases (NCDs).

Delegates called on WHO to promote access for all people to affordable cancer diagnosis and treatment and to provide countries with technical guidance on identifying and implementing priority cancer control interventions.

7. Tobacco control

Delegates adopted a decision requesting that the Conference of the Parties (COP) to the WHO Framework Convention on Tobacco Control (FCTC) provide information on outcomes of their biennial meeting to future World Health Assembly meetings. The WHO FCTC Secretariat was identified as the conduit for requesting and sharing this this information. They also requested the WHO Director-General to provide information on relevant tobacco-related Health Assembly resolutions and decisions to future meetings of the COP. The eighth session of the COP will be held from 1-6 October, 2018, in Geneva, Switzerland.

8. Childhood Obesity

Delegates welcomed a plan to implement recommendations made by the WHO Commission on Ending Childhood Obesity. The recommendations aim to reverse the rising trend of children and adolescents becoming overweight and obese. The implementation plan highlights the importance of tackling environments that facilitate access to and promotion of unhealthy foods and make it hard for children to be physically active. It focuses on preventing obesity throughout the life course, from the earliest years.

The implementation plan aims to help countries to fulfil commitments on addressing obesity that they have already made. These include pledges contained in the WHO global action plan for the prevention and control of NCDs, the comprehensive implementation plan for maternal, infant and young child nutrition and as part of the 2030 Agenda for Sustainable Development.

The implementation plan stresses encouraging infants and young children to choose healthy foods through supportive policies and interventions, including taxation, marketing and labelling. The plan focuses on supporting and building healthy habits that last through the life course. It also highlights the need for shaping school environments and curricula as well as community environments to support healthy lifestyle choices – including the taking of physical exercise.

The plan includes recommendations on interventions to treat overweight and obesity in children, plus measures to prevent unhealthy weight gain in infants and young children.